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My Book

While Forest [Laboratories] applied to the FDA for pediatric use of Celexa [the anti-depressant] and was eventually denied, the company admitted it had marketed the drug to doctors by hiring speakers to tout its benefits for young patients. Forest also admitted it had suppressed the negative results of research in Europe that found Celexa was no more effective in treating depressed children and adolescents than a sugar pill. Fourteen young patients in that study attempted suicide or contemplated suicide, compared with five in the placebo group, court records show.

From this article. Is Forest Laboratories worse than other big drug companies? Probably not. What’s horrible is how this sort of thing — suppression of negative results — keeps happening. It suggests that the evaluation of drugs should be taken entirely out of the hands of drug companies.

Are there any laws preventing drug companies from pointing out the flaws in the drugs of their competitors? It seems like that would be a natural way to find this sort of thing out. Just like “negative campaign ads” are more informative – and more convincing – than positive ones, you could imagine a drug market in which the drugs that objectively did best were advertised as such (and false claims were investigated by the media and/or the courts as possible fraud). You could even include a standardized URL where all the fine print caveats are listed (instead of scrolling past pages of fine print spoken by a fast-talker)

Another thing to consider is that FDA approval is too binary: “approved” or “unapproved”. If we made FDA approval optional it seems likely something like Consumer Reports would come about to arbitrate not just whether drugs work but *how well* they work. Including ranking drugs against each other to see what the comparative advantage is.